10 legalities involved in dry needling

1. DR. SUBHANJAN DAS, PT
Subhanjan_82@yahoo.co.in
+91 8967549104
Dry Needling Instructor
MPT (Musculoskeletal & Sports)
Assoc. Prof., BIMLS, Burdwan

2. Also in the series
 http://www.slideshare.net/SubhanjanDas/introduction-to-dry-needling
 http://www.slideshare.net/SubhanjanDas/2-brief-hisory-of-needling
 http://www.slideshare.net/SubhanjanDas/3-superficial-dry-needling
 http://www.slideshare.net/SubhanjanDas/4-indications-of-dry-needling
 http://www.slideshare.net/SubhanjanDas/6-dangers-of-dry-needling
 http://www.slideshare.net/SubhanjanDas/7-physiologic-background-of-dryneedling
 http://www.slideshare.net/SubhanjanDas/8-dn-vs-acupuncture
 http://www.slideshare.net/SubhanjanDas/9-electroacupuncture
 http://www.slideshare.net/SubhanjanDas/10-legalities-involved-in-dry-needling

3. Issue: is it within the scope of
physiotherapy?
 Dry needling is practiced by physical therapists in
many countries, including South Africa, Bangladesh,
the Netherlands, Spain, Switzerland, Canada, Chile,
Ireland, the United Kingdom, Australia and New
Zealand1

4. Issue: is it within the scope of
physiotherapy?
 Of the approximately 9,000 physical therapists in
South Africa, over 75% are estimated to employ the
technique at least once daily2

5. Issue: is it within the scope of
physiotherapy?
In the United States 33 states allow dry needling by
physiotherapists, 4 states ( California, Hawaii, New
York, and Florida) prohibit practice of dry needling, in
fact they do not allow physical therapists to penetrate
the skin1,3.
Rest of the states do not have clear guidelines regarding
physical therapists practising DN.

6. Issue: is it within the scope of PT?
As DN is a comparatively new modality, many
authorities are in the process of recognizing DN,
example, Arizona State Board of Physical Therapy
allowed PTs to perform DN only in 22 Oct 20134!
HISTORICAL PERSPECTIVE
 In the initial days of spinal manipultion Dr. Janet
Travel discouraged Stanley Paris from manipulation by
saying, “Manipulation is a diagnostic and therapeutic
tool to be reserved for physicians only.”5

7. Scenario in India
 No clinical practice guideline exists regarding
physiotherapy.
 The D&C act 1940 prevents PT’s to administer
prescription drugs. Dry needling does not use any
drug.
 Lidocaine or corticosteroids, sometimes injected to the
trigger point can not be independently administered
by a physio.

8. Who can perform acupuncture?
Various organizations run acupuncture courses, e.g.
Singhania university (UGC & AICTE approved)has a
certificate course where the eligibility is 10th pass. The
web is full of certificate, diploma, degree and even MD
courses. There is need for definitive guidelines.

9. Final word
Physiotherpists in India can legally perform needling
within present system.
It is highly unlikely that this locus standi will change in
future.

10. 1. http://en.wikipedia.org/wiki/Dry_needling
2. Dommerholt et. al, Trigger point dry needling, The
Journal of Manual & Manipulative Therapy Vol. 14
No. 4 (2006), E70 - E87
3. Hawaii Revised Statutes. Chapter 461J; Physical
Therapy Practice Act. Article §461J-2.5 Prohibited
practices, 2006.
4. http://www.ptboard.az.gov/docmgt/docs/dryneedli
ngbyPT.pdf
5. Paris SV. In the best interests of the patient. Phys
Ther 2006;86:1541-1553.